| NPI | 1023138435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: NC 2007-00937) |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: LA S-332) |
| 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CA 48857) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: LA 200649) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: NC 2007-00937) | |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2012-09-20 |